Provider Demographics
NPI:1962471342
Name:CRESCENZI, ZINA I (APRN)
Entity Type:Individual
Prefix:MS
First Name:ZINA
Middle Name:I
Last Name:CRESCENZI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ZINA
Other - Middle Name:I
Other - Last Name:MIRMINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1450 CHAPEL STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-789-3275
Mailing Address - Fax:203-789-3222
Practice Address - Street 1:1450 CHAPEL STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-789-3275
Practice Address - Fax:203-789-3222
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001740363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS61704Medicare UPIN
CT500000556Medicare ID - Type Unspecified